TALKING POINTS ON THE 2014 EBOLA OUTBREAK
Some talking points on Ebola viruses are below to help you respond to questions that your clients may have.
• Ebola disease first was recognized in Sudan in 1976 (600 cases with a case fatality rate from 55% to 90% in two geographic areas).
• Outbreaks occurred in the same area in 1977 and 1979.
• A new strain was identified in 1994 (person infected from dissecting an infected chimpanzee).
• Outbreaks from 1994-2008:
o 1994-1996: 150 cases/98 deaths (Gabon)---65% Case Fatality Rate (CFR)
o 2000-2001: 425 cases/225 deaths (Uganda)---53% CFR
o 2001-2003: 278 cases/235 deaths (Gabon & Dem. Rep. Congo)---85% CFR
o 2005: 20 cases/5 deaths (Sudan)----0.8% CFR
o 2007: 249/183 deaths (Democratic Republic of the Congo)---73% CFR
o 2007-2008: 491 cases/ 39 deaths (Uganda)---8% CFR
• Ebolavirus Reston subtype was found in cynomolgus monkeys shipped to the U. S. from the Philippines in 1989, 1990 and 1996. Many of the monkeys died. In 1989 four animal handlers with close daily monkey contact developed antibodies to the virus but did not become ill.
• The reservoir presently is unknown, but there is good evidence that initial infection of people is associated with collection of bush meat (recently dead animals) in the rainforest.
• Large numbers of deaths in chimpanzees and gorillas are sentinels for virus activity.
• There is recent evidence that bats may be reservoirs for infection in people.
TRANSMISSION IN PEOPLE
Person-person: Direct contact with infected blood, secretions, organs or semen.
• Surveillance and early recognition of transmission.
• Quarantine of suspect cases.
• Medical isolation of cases (barrier nursing and biosecurity).
PERIOD OF COMMUNICABILITY
• The virus is not transmitted in people before a fever develops.
• Transmission occurs through direct contact with body fluids.
• There is no evidence of aerosol transmission or transmission by vectors such as mosquitoes and ticks.
The present outbreak is unusual in the number of cases and countries involved; however, there is no need for people outside West Africa to be overly concerned. Lack of physicians/nurses and the need for families to care for the sick has enhanced transmission in the region. The involvement of both the Centers for Disease Control & Prevention (CDC) and the World Health Organization (WHO) should help to bring this outbreak under control.
REFERENCE AND WEB SOURCE OF ADDITIONAL INFORMATION
Control of Communicable Diseases Manual, David L. Heymann, MD, Editor, American Public Health Association: 2008, 746 pp.